Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
An epidemic is defined as occurring when "new cases of a certain disease, in
a given human population during a given time period, substantially exceed what
is expected based upon recent experience." Pediatric
obesity has reached
epidemic proportions when compared with just 20 years ago. The goal of this
article is to explore this phenomenon and understand the potential consequences
should this pattern continue.
Childhood obesity facts
Adult and childhood obesity have increased substantially in the last 30
years. Currently, 31% of adults and 18% of
children are
obese, as defined by their
body mass index (BMI).
The vast majority of obesity represents an imbalance in calories ingested vs.
calories expended. Other causes of obesity (metabolic, medicines, and other
diseases) are very rare.
Losing body fat requires both caloric restriction and daily vigorous
exercise.
The immediate and long-term consequences of obesity include physical,
psychological, and economic issues.
Obesity prevention will require both a personal and social/cultural change in
lifestyle. A large volume of current research will help clarify what will be
most helpful.
What is childhood obesity? How is childhood
obesity diagnosed?
In order to systematically describe obesity, the concept of body mass index
(BMI) was developed. BMI is the ratio between an individual's weight to height
relative to their gender and age. BMI addresses the following question: Is the weight of
the subject in excess of what is healthy for a given height? Generally (but not
always), BMI correlates with the amount of body fat, but it is not a measurement
of fat. An individual who has more than the average muscle mass for a given
height (for example, weight lifters) will have an elevated BMI but
clearly will not be obese. Nomograms for both adults and children have been
developed to graphically represent the range of normal when measuring BMI. An
individual is overweight when their BMI is between 25.0-29.9. Obesity is defined
as a BMI greater than 30.0. Many web sites have calculators to measure BMI (for
example, http://www.cdc.gov/healthyweight/assessing/bmi/). Measuring body fat may be
done via skin-fold-thickness measurement, waist-to-hip-circumference ratio and
neutral buoyancy (water displacement) measurements. BMI is not used for children
under 2 years of age and instead growth charts should be used to identify any weight issues.
Reviewed by David Perlstein, MD, MBA, FAAP on 6/25/2012
Q: I'm pregnant and have a family history of obesity. How can I prevent my child from becoming obese?
Medical Author: Dennis S. Phillips, MD
Medical Editor: Melissa
Conrad Stöppler, MD
A: A report from the Institute of Medicine this year found
that one-third of American children and youths are either obese or at risk
for obesity. Over the past 30 years, the obesity rate has nearly tripled for
children 2-5 years old (from 5% to 14%) and youths 12-19 years old (5% to
17%), and it has nearly quadrupled for children 6-11 years old! We now know that
infants are at greater risk for obesity if their moms gain excessive weight
during pregnancy.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type
Gallstones are stones that form when substances in the bile harden. Gallstones (formed in the gallbladder) can be as small as a grain of sand or as large
There are many types of thyroid disease. Some occur due to the function of the thyroid itself such as hypothyroidism, hyperthyroidism, Hashimoto's thyroiditis,
Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain,
Polycystic ovarian syndrome (PCOS), also known by the name Stein-Leventhal syndrome, is a hormonal problem that causes women to have a variety of symptoms
Nonalcoholic fatty liver disease (NAFLD) refers to a wide spectrum of liver disease ranging from simple fatty liver (steatosis), to nonalcoholic steatohepatitis
Anorexia is an eating disorder characterized by markedly reduced appetite or total aversion to food. Anorexia is a serious psychological disorder and is
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA),
Asthma, the main cause of chronic illness in children, has signs and symptoms in children that include frequent coughing spells, low energy while playing,
Bulimia is an eating disorder characterized by episodes of secretive excessive eating (bingeing) followed by inappropriate methods of weight control, such
The time when boys and girls begin the process of sexual maturation is called puberty. During this time, both sexes undergo a series of biological changes
Depression in teenagers may be caused by many factors. Symptoms of teen depression include apathy, irresponsible behavior, sadness, sudden drop in grades,
Prader-Willi syndrome is a condition characterized by severe floppiness (hypotonia), poor growth, delayed development, and poor feeding problems in early
Good parenting helps foster empathy, honesty, self-reliance, self-control, kindness, cooperation, and cheerfulness, says Steinberg, a distinguished professor
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs
Regular exercise can help reduce the risk of heart disease. To achieve maximum benefits, do a mix of stretching exercise, aerobic activity, and strengthening
Teenagers recognize that they are developmentally between child and adult. Teen health prevention includes maintaining a healthy diet, exercising regularly,
